Global cognitive function before,surrounding, and after ischemic stroke: the role of risk and protective factors varies with time among ischemic stroke survivors

An estimated 65% of individuals demonstrate multidomain cognitive impairment poststroke, although little is known about the varying role of cognitive risk and protective factors in preischemic, peri-ischemic, and postischemic stroke phases. Longitudinal changes in global cognitive function after ischemic stroke are not well characterized, especially in older adults over age 80. We examined global cognitive function trajectories in these three phases across a mean follow-up of 8.12 (2.30) years in 159 female stroke survivors aged 65–79 at baseline using linear mixed models with change points. In separate models controlling for demographic variables, we tested the interaction of baseline risk and protective factors with stroke phase on global cognitive function. None of the prestroke global cognitive function means or trajectories differed significantly. At the time of ischemic stroke, higher body mass index (BMI), the presence of hypertension (HTN), low optimism, and higher physical function were all associated with significantly greater mean decreases in global cognition (all p’s <.0.0001), but were not significantly different from the contrasting level (all p’s >0.05). Higher BMI, the presence of HTN, low optimism, and higher physical function were in turn protective of global cognitive decline postischemic stroke (all contrasting p values <.01). Baseline factors may play either a risk or a protective role in global cognitive function depending on the phase of ischemic stroke.     

Learning to feel at home. Governing homelessness and the politics of affect

The emotional and affective dynamics of homelessness are an established matter of concern in geographical research. Geographers have called attention to homelessness as an embodied phenomenon and to the emotional distress that affects people experiencing homelessness. What has achieved less attention though are the politics of affect that characterize spaces of care. Attempts to make homeless people ‘housing ready’ often target emotions and try to provide clients with a sense of belonging and feelings of responsibility in matters of housekeeping and homemaking. The paper takes these attempts to create emotionally stable ‘housing ready’ selves as a point of departure to open a set of broader questions concerning the nature of encounters between the welfare state and its citizens. It shows how spaces of care address ‘housing readiness’ as a personal ability and thereby abstract from the complex affective entanglements and prepersonal conditions that characterize dwelling. To highlight the paradoxical effects of therapeutic approaches to dwelling as a subjective emotional skill that can be mastered, I contrast the notion of ‘housing readiness’ with recent work in the field of affective geographies that allows for a different articulation of dwelling as a dense web of practices, atmospheres and relations between people, spaces and things.     

整体运动知觉老化伴随颞中回静息态功能改变

以个体整体运动一致性阈值为指标, 探讨老年人整体运动敏感性(GMS)下降和静息态下兴趣脑区功能活动的关系。发现与阈值负相关且老年人低于青年人的指标主要有：MT/V5区的ReHo和ALFF值, 各网络拓扑属性; 与阈值正相关且老年人显著高于青年人的有：MT/V5区与前运动皮层之间的、各兴趣脑区之间的功能连接。结果用“去分化”等观点进行了解释, 提示老年人GMS的下降可能不仅与安静状态下MT/V5区的功能改变有关, 还可能与全脑更广泛区域的功能改变有关。     

Telehealth mask wearing training for children with autism during the COVID‐19 pandemic

SARS‐CoV‐2 is the virus causing COVID‐19 and is spread through close person‐to‐person contact. The use of face masks has been described as an important strategy to slow its transmission. We evaluated the effects of coaching caregivers via telehealth technologies to teach face mask wearing to children with autism spectrum disorder. Six participants with a history of challenging behavior associated with mask wearing were recruited from different parts of the world, and trained using graduated exposure, shaping, and contingent reinforcement. By the end of the intervention, all participants wore a face mask for a period of 10 min without exhibiting challenging behavior. The skills generalized to a novel mask or a community setting. Mask wearing did not affect the percentage of oxyhemoglobin saturation of participants, and caregivers found the intervention useful. The findings support previous tolerance training treatment evaluations in children with developmental disorders exhibiting resistance to healthcare routines.     

老年人整体运动知觉衰退的视觉机制——基于知觉模板模型

整体运动知觉存在年龄相关的衰退,然其老化的视觉机制仍不清楚。本研究分别招募34名青年人和老年人为研究对象,采用随机点阵范式,首次以动态速度为外部噪声考察了这一问题。结果发现,老年组整体运动一致性阈值显著高于青年组,且中等速度下的差异较小,证明整体运动知觉存在老化效应,且老化程度受到速度的影响。对两组数据进行知觉模板拟合发现,以青年组为基准,老年组表征内部加法噪声和排除外部噪声能力的 A_a 和 A_f 均大于1,且 A_a >> A_f ,提示老年人整体运动知觉的衰退可能源于其内部加法噪声的增强和排除外部噪声能力的减弱,其中内部加法噪声的增强更为显著。     

Training and Supervising Lay Providers in Kenya: Strategies and Mixed-Methods Outcomes☆☆☆

ObjectiveTraining lay providers to deliver mental health interventions is both effective and cost-effective. However, more research is needed to document training and supervision procedures and to collect lay providers’ feedback.MethodsThis study documents training and supervision from a randomized controlled trial of the Shamiri intervention, a four-session, school-based intervention that significantly reduced symptoms of anxiety and depression in Kenyan adolescents. We delivered a 10-hour training to 13 lay providers, M (SD)_age = 21.00 (1.95), %_female = 61.54. We also hosted 30-minute supervision meetings twice weekly. Training and supervision were delivered primarily by undergraduates. Independent raters coded session recordings for fidelity and quality of services, and we collected quantitative and qualitative feedback from lay providers.ResultsReliability and mean ratings for all six of our fidelity and quality measures (delivering required content, adhering to specified details, thoroughness, skillfulness, clarity, and purity) were very good to excellent. Lay provider quantitative ratings of training were also overwhelmingly positive, with an overall satisfaction rating of 6.46/7.00. We identified central qualitative themes in lay provider comments: Generally, comments about training style, content, and personal interactions were overwhelmingly positive, and many lay providers reported personal growth. Comments about timing and location of training were mixed.ConclusionsThis study provides preliminary evidence that a very brief training delivered primarily by undergraduates can teach high school-graduate lay providers to deliver effective mental health interventions. Additionally, we discuss lessons learned and implications for future research, including the importance of considering local context when planning and of continuously collecting and addressing lay provider feedback.     

Life-Ecology Integrated Security in Building a Global Community of Health for Human Beings

The sudden onslaught of the COVID-19 pandemic brought people the most serious global public health emergency since the end of World War II. Posing a threat to human survival and development, the pandemic has given prominence to global issues concerning life safety and ecological security and triggered studies on their integrated advancement. Only by fully understanding the importance and urgency of the life-ecology integrated security and establishing the new idea, new strategy, new plan, and basic path can we survive deadly emergencies, build a community with a shared future and health for all, and jointly contribute to and share the benefits of a safe, healthy and beautiful world with common prosperity, long-lasting peace and stability of humanity.     

Counting the Consequences

James's Fairness in Trade seeks to offer an account of fair trade that is “internal” to an existing practice he describes as “mutual market reliance.” This paper distinguishes several senses of the distinction between “internal” and “external” that occur in the book and asks how, in its various senses, the distinction shapes and influences judgments about the fairness of the practice.     

Endless Qualifications,Restless Consumption: The Governance of Novel Foods in Europe

Functional foods and foods derived from genetically modified organisms represent two forms of intervention in the design of foodstuffs that have given rise to distinct political and regulatory dynamics. In Europe, regulatory agencies have tried, unsuccessfully, to affix a definitive legal meaning to these categories of food artificiality. This incomplete process of legal disambiguation has gone hand in hand with the delegation of the responsibility for overseeing new products to consumers, who are asked to continuously consider and assess the qualities of foods when making their choices in the marketplace. In the case of genetically modified foods, we have witnessed strategies of avoidance premised on the consideration of genetic modification as a blemish on the conventional character of foodstuffs. Functional foods, on the other hand, are increasingly mobilized in practices of naturalistic enhancement. What both examples have in common is the open-ended character of their respective regulatory regimes, and the continuous prodding of consumers to involve themselves more intensely in the weighing of their food choices. The result is a particular mode of market activism that we describe as restless consumption.     

Charles Darwin: Continuity,Teleology and Ideology

Climate change has mutated from being a physical phenomenon to be studied to an idea to be contested. The sites of adjudication between competing truth claims have therefore moved from the secluded academy and scientific peer review to the vociferous agora and the extended peer community. This move is illustrated here using the case of the shrinking glaciers of Mt Kilimanjaro. Both the British engineer Guy Callendar, in 1944, and the American campaigner Al Gore, in 2006, claimed that the primary cause of this glacial recession was rising world temperature. Both were passionate believers in the reality of human-induced global warming, but they had very different resources at their disposal to advance these beliefs. While Callendar's claim was revealed only to the editor of the science journal Nature, Gore's claims were visible to millions through his film An Inconvenient Truth. While the force of Callendar's claim was weighed and adjudicated by one peer reviewer, the validity of Gore's claim was tested very publicly in the British courts. Both claims about the cause of Kilimanjaro's retreating glaciers were found wanting. The paper argues that this simple, but powerful, comparison between identical claims-making drawn from two different eras of science, yet with contrasting processes of truth-adjudication, illuminates the different ‘post-normal’ world of science climate change now inhabits. The case study is used to reflect on the role of the extended peer community in establishing and validating scientific knowledge about climate change: who participates, how trust is stabilised and whether science is thereby democratised.